Methadone Management of Withdrawal Associated With Loperamide-related Opioid Use Disorder
Raphael J Leo1, Muhammad A Ghazi, Kelly S Jaziri
1Department of Psychiatry (RJL, KSJ); Department of Family Medicine (MAG), University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, NY.
Loperamide, an anti-diarrheal, is increasingly abused, leading to dependence and withdrawal. This case highlights the need for managing loperamide withdrawal, particularly in patients with opioid use disorder.
Area of Science:
- Pharmacology
- Toxicology
- Addiction Medicine
Background:
- Loperamide hydrochloride is an over-the-counter medication used for diarrhea.
- It acts on mu-opioid receptors in the gut.
- Preclinical studies indicated a low potential for abuse.
Observation:
- Increasing reports of loperamide abuse, dependence, and withdrawal are noted.
- A case of opioid use disorder due to excessive loperamide use is presented.
- Withdrawal management with methadone was required.
Findings:
- Abrupt discontinuation of loperamide can lead to withdrawal symptoms.
- Management strategies for loperamide withdrawal are not well-documented.
- Long-term treatment considerations for loperamide abuse are significant.
Implications:
- Healthcare providers should be aware of the abuse potential of loperamide.
- Further research is needed on safe and effective withdrawal protocols.
- Clinical guidelines may need to address loperamide misuse in patients with substance use disorders.
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